Nursing Elites

1. The nurse is planning discharge teaching for four mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?

• A. A primiparous woman who has recently migrated to the US with her spouse
• B. A multiparous client who lives with her husband and his family members
• C. A multiparous female with a large family living in a community
• D. A primiparous adolescent living at home with her parents and significant other

Correct answer: A

Rationale: A primiparous woman who has recently migrated to the US with her spouse is at the highest risk for psychological difficulties during the postpartum period. Recent migration and adjustment to a new environment can increase the risk of postpartum depression, especially when combined with the challenges of being a new mother. Choice B, a multiparous client living with her husband and his family, may have social support from family members, which can be protective against psychological difficulties. Choice C, a multiparous female with a large family living in a community, also indicates potential social support. Choice D, a primiparous adolescent living at home with her parents and significant other, may have a support system in place with her family and significant other.

2. Which of the following pairs of bases is present in the rungs of the ladder-like structure of deoxyribonucleic acid (DNA)?

• A. Cytosine with guanine.
• B. Rhodamine with biotin.
• C. Diaminopurine with ribozyme.
• D. Serine with tyrosine.

Correct answer: A

Rationale: The correct answer is A: Cytosine with guanine. In the DNA double helix, cytosine always pairs with guanine forming a base pair, and adenine pairs with thymine. These complementary base pairs form the rungs of the ladder-like structure of DNA. Choice B, Rhodamine with biotin, is incorrect as they are not base pairs found in DNA. Choice D, Serine with tyrosine, is incorrect as they are amino acids, not DNA bases. Choice C, Diaminopurine with ribozyme, is also incorrect as ribozyme is an enzyme, not a base, and diaminopurine is not one of the standard bases found in DNA.

3. Which of the following conditions is considered a multifactorial problem?

• A. Cystic fibrosis
• B. Down syndrome
• C. Diabetes mellitus
• D. XYY syndrome

Correct answer: C

Rationale: The correct answer is 'Diabetes mellitus' because it is a multifactorial disease, influenced by both genetic predisposition and environmental factors. Cystic fibrosis (choice A) is primarily a genetic disorder caused by mutations in the CFTR gene. Down syndrome (choice B) is due to an extra copy of chromosome 21. XYY syndrome (choice D) is a genetic condition where males have an extra Y chromosome. These conditions are not considered multifactorial as their origins are primarily genetic.

4. Does the probability of having a child with Down’s syndrome increase with the age of the parents?

• A. TRUE
• B. FALSE
• C. Sometimes
• D. Never

Correct answer: A

Rationale: The correct answer is A: TRUE. Advanced parental age, particularly maternal age, is associated with an increased risk of Down's syndrome in offspring. As parents get older, the likelihood of having a child with Down's syndrome increases. Choices B, C, and D are incorrect because the risk of Down's syndrome is known to rise with parental age, especially maternal age, due to the increased likelihood of chromosomal abnormalities during egg formation.

5. A client comes to the clinic for her first prenatal visit and reports that July 10 was the first day of her last menstrual period. Using Nagele’s Rule, the nurse calculates the estimated date of birth for the client to be _________.

• A. 4/17.
• B. 4/10.
• C. 5/10.
• D. 5/17.

Correct answer: A

Rationale: Nagele's Rule is a common method used to estimate the due date. To calculate it, subtract 3 months and add 7 days to the first day of the last menstrual period. In this case, if the last menstrual period started on July 10, subtracting 3 months (April) and adding 7 days gives an estimated due date of April 17. This is the correct answer. Choices B, C, and D are incorrect because they do not follow the Nagele's Rule calculation method.

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